Tuesday, May 31, 2005

FDA approves generic foscarnet

We received this notice from the U.S. Food and Drug Administration:

FDA issued an approval on May 31, 2005 for a generic formulation of foscarnet sodium injection, 24 mg/mL, 250 mL and 500 mL single-dose containers, manufactured by Pharmaforce, Inc., of Columbus, Ohio. The product is indicated for the treatment of CMV retinitis in patients with acquired immunodeficiency syndrome (AIDS), making a generic alternative formulation available in the United States.

The product is a generic version of Foscavir (foscarnet sodium Injection) 24 mg/mL, 250 mL and 500 mL single-dose containers, manufactured by Astra Zeneca, originally approved in 1991.

Foscarnet/Foscavir is not currently on the formulary for the Texas HIV Medication Program.

Monday, May 30, 2005

Join the Caravan to End AIDS

C2EA--the Caravan to End AIDS--calls for action:

Join the Campaign to End AIDS (C2EA)! An exciting new coalition of people living with HIV/AIDS, our advocates, organizations, and coalitions, united in action with our allies to chart a new course towards an end to the AIDS pandemic.

This summer, we are calling on people living with HIV/AIDS and organizations that serve them. We are mobilizing the veterans of the AIDS movement and a new generation of fighters. We are raising the stakes by organizing ten caravans of AIDS activists to travel through all 50 states in America this fall. We will stop in cities and towns along the way to meet people fighting this disease. Together, we will draft a Road Map to End AIDS, learned from the hard won lessons of two and a half decades of survival. And in October, these caravans will converge in Washington DC for five days of action and a March to End AIDS.

Start your summer by joining us in this concerted mobilization of the AIDS movement. Go to www.EndAIDSNow.ORG and register.

Once you sign-on, you will receive information on how to:

  • Become a rider on a caravan or help organize the route coming through your state.
  • Organize local welcome committees and media events.
  • Participate in fundraising efforts and attend local fundraising shindigs.
  • Connect with like-minded people from around the country and sharpen your media, fundraising, and organizing skills.

We have the tools to end the AIDS pandemic, Let's use them!Visit www.EndAIDSNow.Org and register TODAY.

On Memorial Day, we have many brave souls to thank and remember. In the AIDS epidemic, there are also many to remember. Texas AIDS Network has a banner that we sometimes trot out for events. It says "Texas Remembers, Texas Responds." Remembrance is important. So is responding. C2EA looks like a good way to respond.

Friday, May 27, 2005

Coburn on Condoms

Sen. James Coburn (R-OK) apparently gives a regular lecture for young folks who work or intern at the U.S. capitol--and all around Oklahoma, too--about STD's. The Washington Post has a lively article about the most recent lecture along with some feedback/commentary by Bill Smith, vice president of the Sexuality Information and Education Council of the United States. The lecture included some ghastly pictures of untreated STD's as well as some telling questions and answers.

The Senator, who is both politically and religiously conservative and who has frequently weighed in on AIDS-related federal policy, also talked about condoms.

During his 40-minute slideshow, Coburn avoided any spiritual overtones and spoke in his usual brisk clinical way. Still, Smith detected bias, taking issue, for example, with Coburn's contention that condoms are only 69 percent effective in preventing HIV; Smith says the latest studies show condoms to be 99 percent effective.

But Smith did give Coburn credit for saying during the question-and-answer portion, "Condoms do reduce the risk of transmission, and they work very well against HIV. If you decide to do any risky sexual behavior, use a condom."


That's the money quote, so to speak. We may as well ignore the apparent contradiction between his lecture and his answers to questions; it might be fun to be a bit snarky about it, but there's not much benefit there. Instead, we should all make a fast note that Coburn is quoted, as highlighted above, by Hanna Rosin in The Washington Post, May 27, 2005, page C01. The subject will come up again--and that quote will be most useful.

Wednesday, May 11, 2005

Five Questions: The Second Question

Tackling the second question second, the question is:

2) What degree do you hold and what other jobs have you held before your job with Texas AIDS Network?

After answering the fifth question, you might be able to guess a bit about my education. I really, really wanted to be an astronomer when I was finishing high school and getting ready for college. That's because I figured that an astronomer would be needed to help navigate when we started exploring beyond the solar system, and I wanted a spot on the ship.

As it turns out, I was better prepared in English than in math and science, so I ended up majoring in English for my first degree. I did some graduate work in English, but I was still looking for those long voyages beyond my boundaries anyway, so I eventually switched my major to Anthropology. I completed both a Master of Arts and a Doctor of Philosophy in that field.

Jobs. Not so many. Teacher. Researcher. Association executive. I taught Swahili. I did research in Swahili. I was ED for a nursing association (although I am not a nurse).

The answer to your question should reveal my qualifications--or at least my interest--in HIV as a prelude to becoming Executive Director of Texas AIDS Network. Since I seem not to have done that, I'll tackle the answer in a slightly different way.

Texas AIDS Network focuses at the moment on access to HIV medications. We may--and have--shift our focus to prevention issues or service issues or other things as time and resources permit. But right now, our major concern is how to get medications to Texans living with HIV/AIDS.

As part of our focus we do research on the system that provides access to medications. We look at public systems, we look at private systems. My research skills are what come in handy here. We also conduct educational activities. We present seminars and workshops, conference presentations. We develop learning tools for clients and providers. My years of teaching come in handy here. We also look at where the system--that we have studied and talked about in educational forums--needs to be improved or better funded. That involves advocacy, both in terms of providing information to the community about the issues that we have discovered and going directly to policy makers to seek those changes.

As it happens, nothing in my academic background prepared me for the advocacy component. I picked up that skill set when my neighborhood was threatened by a development that we didn't want. From there came coalition building, appointment to an advisory board, and running a political campaign. These were all volunteer positions, but they gave me a lot of experience from several angles for working on policy.

As for HIV, there is both a personal and an intellectual component to my coming to this job. On one of those last trips to Africa, sort of my last stand as an anthropologist, there was already evidence that something terrible was happening. As a friend in Catholic Relief Services said: "The bodies were stacked up like cordwood in the morgue." Working with the nurses association (my first shot at an actual policy job), I first learned about AIDS and the connection with what I had heard about while in Africa. And then I lost two family members to the epidemic.

When this job came along I was ready. I had the motive and the means; all I needed was the opportunity to try to make a difference. Texas AIDS Network gave me that opportunity.

Monday, May 09, 2005

Five Questions: The Fifth Question

Taking the questions out of order, I'll start with the last question:

5) Do you have any advice for young people like me who are embarking on careers in Public Health?

I've spent a fair amount of time thinking about this one. It would be easy to try for some flippant response like: Have you considered a career in law instead? But there is a crying need for more public health professionals in our country. I don't just mean nurses and physicians and what not. I mean people who are trained to look at health in terms of the whole community. These folks are often emplyed by the government at various levels and, therefore, will by definition be low-paid. They could probably make more money as nurses.

But health is not simply a matter of how I or you are feeling today. It's also about whether we are part of a group of people who are feeling the same way for the same reasons. It's about discovering those reasons and looking for solutions. It's about helping to shape health policies and carrying them out. It's about making our communities healthier, safer, better places to live.

My advice? I suppose there are any number of things that I might recommend, but the one thing that I think I would strongly encourage is that you add a second language to your toolkit.

By this I mean become fluent in another language, not just take a couple of years of college classes.

We are a nation of immigrants. Like it or not, immigration--perhaps legal, perhaps not--will increase in the coming years. Many of our nation's residents do not speak English as their first language. Learning the language of the community that you will be working with will give you extra tools to do your job.

How?

The first thing is what I as a former language teacher (more on this later) particularly liked. By learning a second language you will learn more about your own language and become more skilled in using it. Not that that will help you in public health, but it will make your old English teacher happy.

The second, and more important, is that knowing the language of the community that you will be working with will help give you entre. You will be less "other" and more easily accepted as someone who can be listened to.

The third, and most important, is that knowing the language of the community will allow you to hear more clearly what they are telling you about their problems because they will be more comfortable and articulate in speaking about those problems. The burden of understanding will be placed, of course, on your shoulders but the people you are working with will be able to concentrate on what they want to tell you and not how to tell it.

A fourth thing that is important, but I won't rank it, is that with the language will come some better understanding of the culture in which the language is spoken. This matters. We tend to think of health as a medical issue that is itself all about science. But health is also a cultural concept. What is meant by good health, what is considered to be a healthy practice--these are all influenced by the culture in which we are raised. It's a good thing to recognize, even if we don't know the specific differences between one culture and another, that there are likely to be differences in surprising places. Language can sometimes signal those differences.

I don't work directly with clients on most days, but I can tell you that it was very powerful to attend a hearing on a rule change this summer and see the Commissioner of Health be able to understand a woman's testimony when she spoke in her native language. She first attempted to speak in English, but she was clearly struggling--and most embarassed. The Commissioner allowed her extra time to speak and asked her to speak in Spanish. I had no clue what she was saying (although I--and the Commissioner--already knew her point), but she was so clearly pleased to be able to say her piece then and did so with what appeared to be both skill and passion.

So which language? Depends on the general area where you think you might work. Spanish seems like a good starting place, but Vietnamese or some other language might be used in the area where you end up working. Indeed, you may end up with more than two languages in your toolkit over a lifetime.

My recommendation, after some preliminary classwork, is to just immerse yourself in the language. Read the newspaper, listen to the radio, make some friends. You'll never be a native speaker of the second language, but any progress that you make in learning will pay off with big dividends later on, I think.

If nothing else, certainly learn the basic greetings and courtesies of the language.

Wednesday, May 04, 2005

Five Questions

Brad Biggers over at AIDS Combat Zone took the five question challenge and then tossed it to his readers. I offered to take up the challenge, and he has sent me my five questions.

  1. What do you see as today's biggest barrier to helping people living with HIV/AIDS in Texas?
  2. What degree do you hold and what other jobs have you held before your job with Texas AIDS Network?
  3. Imagine you're given $1,000,000 and told you can only use it to increase funding of one AIDS-related service in Texas, what would it be? (e.g. expanding free testing, outreach to a specific group, ADAP, etc.)
  4. To steal a question from Terrance, If you weren’t doing what you’re doing now in regards to work, what else would you choose if there were no limitations on your choices?
  5. Do you have any advice for young people like me who are embarking on careers in Public Health?

These are some pretty tough questions, so I'll be taking my time in answering them. After all, if I offer that advice, someone might take it--so it had better be good!

Thanks to Brad for offering this challenge. It's already provoking some serious thought.

Texas HIV Appropriations

At this point, the appropriations bill is in Conference Committee. Even though both the House and the Senate have recommended that $15 million in new funding be appropriated for HIV, there is still the odd chance that the committee might decide to take that money to pay for something else. We (Texas AIDS Network and allies) have been keeping a close watch on the situation, just in case we needed to take some sort of additional action.

For the time being, we're thinking that it's best to let sleeping dogs lie.

Why? First, we know that there are some strong allies for HIV on the committee. Senator Zaffirini is practically a one-woman army, and she has a lot of help in unexpected quarters. Second, we spent some time at the capitol on Monday "taking pulses" and checking for indicators that there might be any trouble on the horizon for HIV. What we found was pretty much comforting--no indicators of trouble.

This doesn't mean that we don't have to maintain vigilance, but it does mean that, as the session moves into its final month, there is more reason to be cautiously optimistic that the Texas HIV Medication Program will have the funding that it needs to operate in the coming biennium without cutting services.

I'm back (again)

This is starting to get a little old, I think. We have lost four family members since Christmas (five if you count the cat), and I've just returned from the funeral for a beloved uncle. Let's all hope that this is the last one.

I will be playing catch up yet again. There is, however, much in the Good News Department, so stay tuned.